Jennifer G Buckingham, LCPC | |
9 Hillcrest Ave, Randolph, ME 04346-5131 | |
(207) 582-9206 | |
(207) 582-9653 |
Full Name | Jennifer G Buckingham |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 9 Hillcrest Ave, Randolph, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376760694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | XL2989 (Maine) | Secondary |
101YP2500X | Counselor - Professional | CC3528 (Maine) | Primary |
Entity Name | Spurwink Services Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760507297 PECOS PAC ID: 7810026945 Enrollment ID: O20100527000272 |
Mailing Address | Practice Location Address |
---|---|
Jennifer G Buckingham, LCPC 901 Washington Ave, Portland, ME 04103-2737 Ph: (207) 871-1200 | Jennifer G Buckingham, LCPC 9 Hillcrest Ave, Randolph, ME 04346-5131 Ph: (207) 582-9206 |
Ms. Carla Jane Mowatt, LMSW-CC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9 Hillcrest Avenue, Randolph, ME 04346 Phone: 207-582-9206 | |
Roy E Siegfriedt, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9 Hillcrest Ave, Randolph, ME 04346 Phone: 207-582-4218 Fax: 207-582-4360 | |
Lacey Bourgoin, SLP-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 17 School St, Randolph, ME 04346 Phone: 207-588-2699 | |
Rebecca A Martin, LCPC-C Counselor Medicare: Not Enrolled in Medicare Practice Location: 28 School St, Randolph, ME 04346 Phone: 207-629-7025 |